TY - JOUR
T1 - Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge
AU - Raman, Betty
AU - Cassar, Mark Philip
AU - Tunnicliffe, Elizabeth M.
AU - Filippini, Nicola
AU - Griffanti, Ludovica
AU - Alfaro-Almagro, Fidel
AU - Okell, Thomas
AU - Sheerin, Fintan
AU - Xie, Cheng
AU - Mahmod, Masliza
AU - Mózes, Ferenc E.
AU - Lewandowski, Adam J.
AU - Ohuma, Eric O.
AU - Holdsworth, David
AU - Lamlum, Hanan
AU - Woodman, Myles J.
AU - Krasopoulos, Catherine
AU - Mills, Rebecca
AU - McConnell, Flora A.Kennedy
AU - Wang, Chaoyue
AU - Arthofer, Christoph
AU - Lange, Frederik J.
AU - Andersson, Jesper
AU - Jenkinson, Mark
AU - Antoniades, Charalambos
AU - Channon, Keith M.
AU - Shanmuganathan, Mayooran
AU - Ferreira, Vanessa M.
AU - Piechnik, Stefan K.
AU - Klenerman, Paul
AU - Brightling, Christopher
AU - Talbot, Nick P.
AU - Petousi, Nayia
AU - Rahman, Najib M.
AU - Ho, Ling Pei
AU - Saunders, Kate
AU - Geddes, John R.
AU - Harrison, Paul J.
AU - Pattinson, Kyle
AU - Rowland, Matthew J.
AU - Angus, Brian J.
AU - Gleeson, Fergus
AU - Pavlides, Michael
AU - Koychev, Ivan
AU - Miller, Karla L.
AU - Mackay, Clare
AU - Jezzard, Peter
AU - Smith, Stephen M.
AU - Neubauer, Stefan
N1 - Publisher Copyright:
© 2020
PY - 2021/1
Y1 - 2021/1
N2 - Background: The medium-term effects of Coronavirus disease (COVID-19) on organ health, exercise capacity, cognition, quality of life and mental health are poorly understood. Methods: Fifty-eight COVID-19 patients post-hospital discharge and 30 age, sex, body mass index comorbidity-matched controls were enrolled for multiorgan (brain, lungs, heart, liver and kidneys) magnetic resonance imaging (MRI), spirometry, six-minute walk test, cardiopulmonary exercise test (CPET), quality of life, cognitive and mental health assessments. Findings: At 2–3 months from disease-onset, 64% of patients experienced breathlessness and 55% reported fatigue. On MRI, abnormalities were seen in lungs (60%), heart (26%), liver (10%) and kidneys (29%). Patients exhibited changes in the thalamus, posterior thalamic radiations and sagittal stratum on brain MRI and demonstrated impaired cognitive performance, specifically in the executive and visuospatial domains. Exercise tolerance (maximal oxygen consumption and ventilatory efficiency on CPET) and six-minute walk distance were significantly reduced. The extent of extra-pulmonary MRI abnormalities and exercise intolerance correlated with serum markers of inflammation and acute illness severity. Patients had a higher burden of self-reported symptoms of depression and experienced significant impairment in all domains of quality of life compared to controls (p<0.0001 to 0.044). Interpretation: A significant proportion of patients discharged from hospital reported symptoms of breathlessness, fatigue, depression and had limited exercise capacity. Persistent lung and extra-pulmonary organ MRI findings are common in patients and linked to inflammation and severity of acute illness. Funding: NIHR Oxford and Oxford Health Biomedical Research Centres, British Heart Foundation Centre for Research Excellence, UKRI, Wellcome Trust, British Heart Foundation.
AB - Background: The medium-term effects of Coronavirus disease (COVID-19) on organ health, exercise capacity, cognition, quality of life and mental health are poorly understood. Methods: Fifty-eight COVID-19 patients post-hospital discharge and 30 age, sex, body mass index comorbidity-matched controls were enrolled for multiorgan (brain, lungs, heart, liver and kidneys) magnetic resonance imaging (MRI), spirometry, six-minute walk test, cardiopulmonary exercise test (CPET), quality of life, cognitive and mental health assessments. Findings: At 2–3 months from disease-onset, 64% of patients experienced breathlessness and 55% reported fatigue. On MRI, abnormalities were seen in lungs (60%), heart (26%), liver (10%) and kidneys (29%). Patients exhibited changes in the thalamus, posterior thalamic radiations and sagittal stratum on brain MRI and demonstrated impaired cognitive performance, specifically in the executive and visuospatial domains. Exercise tolerance (maximal oxygen consumption and ventilatory efficiency on CPET) and six-minute walk distance were significantly reduced. The extent of extra-pulmonary MRI abnormalities and exercise intolerance correlated with serum markers of inflammation and acute illness severity. Patients had a higher burden of self-reported symptoms of depression and experienced significant impairment in all domains of quality of life compared to controls (p<0.0001 to 0.044). Interpretation: A significant proportion of patients discharged from hospital reported symptoms of breathlessness, fatigue, depression and had limited exercise capacity. Persistent lung and extra-pulmonary organ MRI findings are common in patients and linked to inflammation and severity of acute illness. Funding: NIHR Oxford and Oxford Health Biomedical Research Centres, British Heart Foundation Centre for Research Excellence, UKRI, Wellcome Trust, British Heart Foundation.
KW - COVID-19
KW - Coronavirus
KW - Follow up
KW - Magnetic Resonance Imaging
KW - Medium term
KW - Mental health
KW - Multiorgan effects
KW - Post-hospital discharge
KW - SARS-CoV-2 infection
KW - Survivors
UR - http://www.scopus.com/inward/record.url?scp=85098963986&partnerID=8YFLogxK
U2 - 10.1016/j.eclinm.2020.100683
DO - 10.1016/j.eclinm.2020.100683
M3 - Article
AN - SCOPUS:85098963986
SN - 2589-5370
VL - 31
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 100683
ER -